Occult Metastases in Negative Sentinel Lymph Node of Invasive Breast Cancer Discovered by Serial Section in Ramathibodi Hospital
Keywords:
Occult metastases, Breast cancer, Sentinel lymph nodeAbstract
Background: Sentinel lymph node (SLN) biopsy is an established method for evaluating axillary metastases in breast cancer. This study was designed to ascertain whether serial sections with haematoxylin and eosin stain could significant improve the detection of occult metastases in sentinel lymph nodes.
Method: Sentinel lymph nodes negative for cancer metastases by routine histology were received from 50 patients with invasive breast cancer in Ramathibodi Hospital between 2006-2007. The lymph nodes were examined by serial sections at 25 microns intervals at each level with haematoxylin and eosin stain.
Result: Occult metastases were detected by serial sectioning in 4 (8%) out of 50 breast cancer patients. One patient had macrometastasis, two patients had micrometastases and one patient had isolated cell metastasis. No clinical or pathological characteristics (age, mammography, tumor size, tumor grading, TNM staging, and number of SLNs) were associated with occult metastases (P- value > 0.05).
Conclusion: The prevalence of occult metastases in negative sentinel lymph nodes of breast cancer patients was quite low in the present study. Serial sectioning sentinel lymph nodes for all patients might not be cost-effective. However, the clinician should be aware of occult metastases in node-negative cases.
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